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SMILE® laser eye surgery


Illustration of SMILE procedure

Small incision lenticule extraction (SMILE) represents the latest generation of vision correction. More than 3 million eyes have been treated using SMILE since it was introduced over 10 years ago.

SMILE is a bladeless, one-step, one-laser procedure. A 3-mm opening is created in the cornea and a precise amount of corneal tissue is removed to correct the patient’s vision. Recovery is quick due to the minimally invasive, keyhole nature of the surgery. However, visual recovery may take slightly longer to stabilise when compared to LASIK.

Who it’s used for

This procedure is an alternative to LASIK for patients with regularly shaped corneas.

It is particularly suited to patients with a high degree of short-sightedness (myopia) and astigmatism.

SMILE may also be suitable for patients who have previously been told they don’t meet the criteria for LASIK. The procedure has less impact on the corneal nerves, making it a better option for those who suffer from dry eyes. And because the cornea heals quicker after SMILE keyhole surgery compared to the flap created for LASIK, it’s an ideal option for people who want to return to contact sports as soon as possible.

Unfortunately, SMILE cannot be used to treat long-sightedness (hyperopia or presbyopia) at this point in time.

The procedure

You will be at the clinic for about 2 hours. The actual procedure takes about 20 minutes.

Make sure you wear warm, comfortable clothes but avoid jumpers that need to be pulled over your eyes. The laser suite can be cold because laser technology requires the room to remain at a constant, cool temperature.

You will be given anaesthetic eye drops to numb your eyes and offered a mild oral sedative to help ease any anxiety. You’ll need to wait for a short period of time to allow your medication to take effect. Following this, you’ll be taken into the laser suite.

After you lie down on the treatment bed, the laser will be moved into place so your eye will be in the line of the laser beam.

Your surgeon will secure your eyelids with a prop called a speculum to ensure that your eye remains open during the laser eye surgery procedure. This allows you to ‘blink’ without actually closing your eyelids.

The bed will then be raised up to the docking point of the laser, which is designed to fit comfortably around your eye with minimal pressure.

Your surgeon will tell you what’s going on at all times, including when the process is about to begin. You may feel a slight pressure on your eye and see a bright light. Because your eyes have been numbed, you won’t feel any pain.

The computer-guided, highly focused laser creates a lens-shaped disc of tissue within the cornea, before making a 3 mm keyhole entry point. Referred to as a lenticule, the size and shape of the lasered cornea corresponds precisely to your refractive error.

The lenticule is removed through the incision. The procedure only takes a few minutes.

The eyelid prop will then be removed and the procedure repeated on your other eye, if necessary.


Following the surgery, you will be moved to the recovery room for about half an hour. This is to allow your eyes time to adjust and you time to recover from the effects of the sedative. A friend or relative will need to take you home, where you should rest for the remainder of the day.

You will be discharged with eye drops to use at home. A post-operative consultation will be made for later the same day or the next day to check your eyes.

Patients typically experience a quick recovery following the SMILE procedure because it is minimally invasive. While most people can see well the next day, it generally takes a few weeks for your vision to stabilise.

Make sure to keep water away from your eyes for a couple of days and avoid rubbing your eyes for a few weeks.

You will be able to return to work and resume driving 2 to 3 days after surgery.


*SMILE® is currently available at Vision Eye Institute Chatswood. SMILE® is a registered trademark of Carl Zeiss Meditec.


  1. Chan C, Lawless M, Sutton G, Versace P, Hodge C. Small incision lenticule extraction (SMILE) in 2015. Clin Exp Optom 2016;99(3):204–12.
  2. Lawless M. Refractive Laser Surgery: Who’s Interested Now? mivision 2019;141:33–37.
  3. Blum M, Lauer AS, Kunert KS, Sekundo W. 10-Year Results of Small Incision Lenticule Extraction. J Refract Surg 2019;35(10):618–23.
  4. Doane JF, Cauble JE, Rickstrew JJ, Tuckfield JQ. Small Incision Lenticule Extraction SMILE – The Future of Refractive Surgery is Here. Mo Med 2018;115(1):82–4.
  5. Zeiss. SMILE: A brief guide. Germany, 2020. Available at https://www.zeiss.com/vision-care/int/better-vision/health-prevention/smile-laser-eye-surgery.html[Accessed 6 January 2021].
  6. Choice. A guide to laser eye surgery. NSW, 11 August 2020. Available at https://www.choice.com.au/health-and-body/optical-and-hearing/optical/articles/guide-to-laser-eye-surgery [Accessed 6 January 2021].

The information on this page is general in nature. All medical and surgical procedures have potential benefits and risks. Consult your ophthalmologist for specific medical advice.

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